Fitting Bilateral Hearing Prostheses

ABSTRACT

Disclosed herein are methods, systems, and computing devices for fitting bilateral hearing prostheses. An example method includes sending a signal to a first hearing prosthesis and a second hearing prosthesis. The signal causes the first hearing prosthesis to deliver a first stimulus to a body part in a left auditory pathway of a user. The signal also causes the second hearing prosthesis to deliver a second stimulus to a body part in a right auditory pathway of the user. The first stimulus and the second stimulus cause the user to perceive a sound and are delivered simultaneously. The method also includes receiving an indication of a perception of the sound by the user. The method further includes determining an adjustment to at least one of the first stimulus or the second stimulus based on the perception of the sound by the user.

BACKGROUND

Due to hearing loss, some individuals have difficulty perceiving or areunable to perceive sound. In order to perceive at least a portion of asound, these individuals may benefit from the use of a hearingprosthesis. Certain hearing prostheses are designed to assist usershaving specific types of hearing loss. In a bilateral hearing prosthesissystem, a user employs a first hearing prosthesis for the user's leftear and a second hearing prosthesis for the user's right ear.

The effectiveness of the hearing prostheses depends on the type andseverity of a user's hearing loss. Furthermore, depending on the hearingprostheses, the user may perceive sound as a person with normal hearing,or the hearing prostheses may allow the user to perceive a portion ofthe sound. The effectiveness of the hearing prostheses also depends onhow well the prostheses are configured for, or “fitted” to, a user ofthe hearing prosthesis. Fitting the hearing prostheses, sometimes alsoreferred to as “programming,” “calibrating,” or “mapping,” creates a setof control settings and other data that define the specificcharacteristics of the stimuli (in the form of acoustic, mechanical, orelectrical signals) delivered to the relevant portions of the person'souter ear, middle ear, inner ear, auditory nerve, or other body part.The control settings are based on the user's type and severity ofhearing loss. This configuration information is sometimes referred to asthe user's “program” or “map.”

SUMMARY

A first method for fitting bilateral hearing prostheses is provided. Thefirst method includes sending a signal to a first hearing prosthesis anda second hearing prosthesis. The signal causes the first hearingprosthesis to deliver a first stimulus to a body part in a left auditorypathway of a user. The signal also causes the second hearing prosthesisto deliver a second stimulus to a body part in a right auditory pathwayof the user. The first stimulus and the second stimulus cause the userto perceive a sound and are delivered simultaneously. The first methodalso includes receiving an indication of a perception of the sound bythe user. The first method additionally includes determining anadjustment to at least one of the first stimulus or the second stimulusbased on the perception of the sound by the user.

A second method for fitting bilateral hearing prostheses is alsoprovided. The second method includes sending a first signal to a firsthearing prosthesis. The first signal includes information indicative ofa first stimulus, which the first hearing prosthesis delivers to a firstbody part in a left auditory pathway of a user. The second method alsoincludes sending a second signal to a second hearing prosthesis. Thesecond signal includes information indicative of a second stimulus,which the second hearing prosthesis delivers to a second body part in aright auditory pathway of the user. The first stimulus and the secondstimulus are delivered simultaneously. The second method furtherincludes determining whether the first stimulus and the second stimulusare at a maximum level. The second method additionally includesdetermining that the first stimulus corresponds to a maximum soundpressure level in response to determining that the first stimulus andthe second stimulus are at the maximum level. Additionally, the secondmethod includes determining that the second stimulus corresponds to themaximum sound pressure level in response to determining that the firststimulus corresponds to the maximum sound pressure level. The maximumsound pressure level is a sound pressure level of a sound above whichthe sound is saturated.

A third method for fitting bilateral hearing prostheses is alsoprovided. The third method includes performing a sweep of electrodearrays included in bilateral hearing prostheses. Performing the sweepincludes causing a first interaural electrode pair to deliver a firststimulation to a user of the bilateral hearing prostheses so that theuser perceives a first sound. Performing the sweep also includes causinga second interaural electrode pair to deliver a second stimulation tothe user so that the user perceives a second sound. The secondstimulation is delivered after the first stimulation. The third methodalso includes receiving an input signal that includes informationindicative of a difference between the first sound and the second soundas perceived by the user. The third method further includes determiningan adjustment to a stimulus current of an electrode included in one ofthe first interaural electrode pair or the second interaural electrodepair. The adjustment is based on the input signal. Additionally, thestimulus current is a component of one of the first stimulation or thesecond stimulation. The third method also includes applying theadjustment to a mapping curve of the electrode. The mapping curveincludes information indicative of a plurality of stimulus currentscorresponding to a plurality of sound pressure levels.

A system for fitting bilateral hearing prostheses is also provided. Thesystem includes a first cochlear implant and a second cochlear implant.The first cochlear implant includes a first electrode array that isimplanted in a left cochlea of a user, and the second cochlear implantincludes a second electrode array that is implanted in a right cochleaof the user. The system also includes a computing device connected tothe first cochlear implant and the second cochlear implant. Thecomputing device is configured to fit the first cochlear implant and thesecond cochlear implant to the user by sending a test signal to thefirst cochlear implant and the second cochlear implant. The test signalcauses an interaural electrode pair to stimulate the left cochlea andthe right cochlea of the user so that the user perceives a sound. Theinteraural electrode pair includes a first electrode included on thefirst electrode array. The interaural electrode pair also includes asecond electrode included on the second electrode array. Additionally,the test signal includes information indicative of a first stimuluscurrent for the first electrode and a second stimulus current for thesecond electrode. The computing device is also configured to fit thefirst cochlear implant and the second cochlear implant to the user bydetermining whether an input signal received at a user interfaceincludes information indicative of a request to adjust the sound. Inresponse to determining that the input signal includes informationindicative of the request, the computing device is further configured tofit the first cochlear implant and the second cochlear implant to theuser by adjusting at least one of the first stimulus current or thesecond stimulus current based on the input signal.

Additionally, a computing device is provided. The computing deviceincludes a user interface configured to receive an indication of anadjustment to a first stimulus and a second stimulus delivered to a userof a first hearing prosthesis and a second hearing prosthesis. Thecomputing device also includes an interface module configured to connectthe computing device to the first hearing prosthesis and the secondhearing prosthesis. The computing device additionally includes aprocessor. The processor is configured to receive an input signal fromthe user interface that includes information indicative of an adjustmentto the first stimulus and the second stimulus. The computing device isalso configured to modify the first stimulus and the second stimulusbased on the adjustment. The computing device is further configured tosend a first signal to the first hearing prosthesis and a second signalto the second hearing prosthesis. The first signal includes informationindicative of a modified first stimulus. The second signal includesinformation indicative of a modified second stimulus. The first signalcauses the first hearing prosthesis to deliver the modified firststimulus to the user at about a same time as the second signal causesthe second hearing prosthesis to deliver the modified second stimulus tothe user.

These as well as other aspects and advantages will become apparent tothose of ordinary skill in the art by reading the following detaileddescription, with reference where appropriate to the accompanyingdrawings. Further, it is understood that this summary is merely anexample and is not intended to limit the scope of the invention asclaimed.

BRIEF DESCRIPTION OF THE FIGURES

Presently preferred embodiments are described below in conjunction withthe appended drawing figures, wherein like reference numerals refer tolike elements in the various figures, and wherein:

FIG. 1A illustrates components of a fitting system used for fittingbilateral hearing prostheses, according to an example;

FIG. 1B illustrates electrode arrays depicted in FIG. 1A, according toan example;

FIG. 1C is a graph of a mapping curve of an electrode depicted in FIG.1B, according to an example

FIG. 2 is a block diagram of a processing unit depicted in FIG. 1A,according to an example;

FIG. 3 is a block diagram of an implanted unit depicted in FIG. 1A,according to an example;

FIG. 4A is a block diagram of a computing device depicted in FIG. 1,according to an example;

FIG. 4B illustrates an example user interface depicted in FIG. 4A,according to an example;

FIG. 5A is a flow diagram of a method for fitting hearing prostheses ina bilateral hearing prosthesis system, according to an example;

FIG. 5B is an illustration of different perceptual locations of a soundby a user of bilateral hearing prostheses, according to an example;

FIG. 6 is a flow diagram of a method for determining currents forinteraural pairs of electrodes, according to an example; and

FIGS. 7A-7C are graphs of mapping curves determined using the methoddepicted in FIG. 6, according to an example.

DETAILED DESCRIPTION

The following detailed description describes various features,functions, and attributes of the disclosed systems, methods, and deviceswith reference to the accompanying figures. In the figures, similarsymbols typically identify similar components, unless context dictatesotherwise. The illustrative embodiments described herein are not meantto be limiting. Certain aspects of the disclosed systems, methods, anddevices can be arranged and combined in a wide variety of differentconfigurations, all of which are contemplated herein.

1. EXAMPLE SYSTEM FOR FITTING BILATERAL HEARING PROSTHESES

FIG. 1A illustrates a fitting system 100 configured to fit bilateralhearing prostheses to a user. The fitting system 100 includes a firsthearing prosthesis 101 and a second hearing prosthesis 102. The hearingprostheses 101, 102 are illustrated as partially implantable cochlearimplants. In another example, the fitting system 100 includes otherhearing prostheses, such as totally implantable cochlear implants, boneconduction devices, direct acoustic stimulation devices, auditory brainstem implants, middle ear implants, and/or any other hearing prosthesesor combination of hearing prostheses suitable for use as bilateralhearing prostheses. The first hearing prosthesis 101 includes a firstprocessing unit 110 and a first implanted unit 112, and the secondhearing prosthesis 102 includes a second processing unit 120 and asecond implanted unit 122. The implanted units 112, 122 are implanted ina portion of a skull of the user. In an example in which the hearingprostheses 101, 102 are totally implantable hearing prostheses, theprocessing units 110, 120 are also implanted in the user's skull.Additionally, a first enclosure may include the first processing units110 and the first implanted unit 112, and a second enclosure may includethe second processing unit 120 and the second implanted unit 122.

The implanted unit 112 includes a first electrode array 114, and thesecond implanted unit 122 includes a second electrode array 124. Thefirst electrode array 114 is implanted in the user's left cochlea, andthe second electrode array 124 is implanted in the user's right cochlea.Each electrode on the electrode array 114, 124 stimulates a portion ofone of the user's cochleae that allows the user to perceive sound havinga range of frequencies. The electrodes in the electrode arrays 114, 124deliver electrical stimuli to one or more portions of the user'scochleae to allow the user to perceive at least a portion of a sound.

FIG. 1B illustrates the first electrode array 114 and the secondelectrode array 124. The first electrode array 114 and the secondelectrode array 124 are implanted in the user's left and right cochleae,respectively. To facilitate implantation, the electrodes arrays 114, 124are made of flexible material suitable for being implanted in the user'scochleae.

The first electrode array 114 includes electrodes L1-L9, and the secondelectrode array 124 includes electrodes R1-R9. In one example, theelectrode arrays 114, 124 may include more or fewer electrodes. Forinstance, the electrode arrays 114, 124 may each include twenty-twoelectrodes. The electrode arrays 114, 124 are implanted such that aninteraural electrode pair—which is defined as one or more electrodes onthe first electrode array 114 that are paired to one or more electrodeson the second electrode array 124—stimulates similar regions of theuser's cochleae. In one example, corresponding electrodes on theelectrode arrays 114, 124 stimulates similar regions of the user's leftand right cochleae and make up an interaural electrode pair. Forinstance, L1 and R1 make up one interaural electrode pair. In anotherexample, the electrode arrays 114, 124 are not implanted in the user'scochleae such that corresponding electrodes on the electrode arrays 114,124 make up an interaural electrode pair. In this example, electrodes L1and R3 make up an interaural electrode pair and stimulate similarregions of the user's left and right cochleae, respectively.

A loudness of the sound perceived by the user of the hearing prostheses101, 102 depends on stimulus currents of the electrical stimuli eachelectrode delivers to the user in response to the processing units 110,120 processing a sound. In general, as the stimulus current increases,the loudness of the sound perceived by the user increases. A value of agiven stimulus current depends on a sound pressure level (SPL) of asound received by one of the processing units 110, 120.

FIG. 1C is a graph 150 of a mapping curve 152 of one of the electrodesincluded on one of the electrode arrays 114, 124. The mapping curve 152is plotted on a log-log scale, with the x-axis representing the SPL of asound in decibels, and the y-axis representing a logarithm of thestimulus current. The stimulus current is expressed in any unit suitablefor use in the hearing prostheses 101, 102. In one example, the unit ismicroamperes. In another example, the unit is any unit capable of beingconverted to microamperes. For illustrative purposes, the mapping curve152 corresponds to the electrode L1.

The electrical dynamic range for the electrode L1 is a differencebetween a threshold level (T-Level) and a maximum comfort level(C-Level). The T-Level for the electrode L1 corresponds to a stimuluscurrent that results in the user just being able to hear a sound at agiven frequency. In other words, the T-Level is the stimulus currentbelow which the user is not able to perceive the sound. The C-Level forthe electrode L1 corresponds to the stimulus current applied by theelectrode to the user's cochlea that results in a maximum loudness ofthe sound at a given frequency that the user can perceive comfortably.That is, the C-Level is the stimulus current above which the userperceives the sound as being painful or uncomfortably loud.

The SPL of the sound at the T-Level is identified as SPL_(T), and theSPL of the sound at the C-Level is identified as SPL_(C). SPL_(T) andSPL_(C) are fixed. In one example, the values of SPL_(T) and SPL_(C)depend on operating characteristics of the components of the hearingprosthesis 101. In another example, the values of SPL_(T) and SPL_(C)depend on the severity of the user's hearing loss at a frequency rangecorresponding to the electrode. A sound having an SPL less than theSPL_(T) is typically discarded by the processing unit 110 and does notresult in stimulation. For a sound having an SPL that is between theSPL_(T) and the SPL_(C), the stimulus current varies approximatelylogarithmically with the SPL of the sound, resulting in the mappingcurve 152 being approximately linear on the graph 150 between SPL_(T)and SPL_(C). For a sound having an SPL greater than SPL_(C), thestimulus current is fixed at the C-Level. In other words, SPL_(C) is thesaturation level for the electrode.

Each of the electrodes L1-L9, R1-R9 has a mapping curve. While users ofthe hearing prostheses 101, 102 may have a similar type of hearing loss(e.g., sensorineural hearing loss), each user may have a uniquesensitivity to stimulation by different electrodes. To accommodate theuser's specific hearing loss, the hearing prostheses 101, 102 are fit tothe user of the hearing prostheses 101, 102 using a computing device106. Fitting the hearing prostheses 101, 102 to the user includesdetermining the T-Level and the C-Level for each of the electrodes L1-L9and R1-R9. A cable 130 is shown as connecting the computing device 106to each of the processing units 110, 120 via a cable 130. In anotherexample, the computing device 106 is wirelessly connected to theprocessing units 110, 120.

To determine the T-Level and/or the C-Level for an electrode on one ofthe electrode arrays 114, 124, the computing device 106 sends a testsignal to at least one of the processing units 110, 120. The test signalincludes information indicative of a stimulus that one or more of theelectrodes L1-L9, R1-R9 should deliver to the user. The test signal alsoindicates a duration of each stimulus, such as a duration of about 500msec. In one example, the user can increase or decrease the duration ofthe stimulus. The processing units 110, 120 determine a stimulationsignal(s) based on the test signal, and send a stimulation signal(s) tothe implanted units 112, 122, respectively. Depending on theapplication, the implanted units 112, 122 use the stimulation signal(s)to cause one or more electrodes on the electrode arrays 114, 124 tostimulate at least one of the user's cochleae.

Example methods for fitting the hearing prostheses 101, 102 aredescribed in more detail with respect to FIGS. 5A and 6.

2. EXAMPLE COMPONENTS OF A SYSTEM FOR FITTING BILATERAL HEARINGPROSTHESES

FIG. 2 is a block diagram of a processing unit 200 of a hearingprosthesis. The processing unit 200 is one example of the processingunits 110, 120 depicted in FIG. 1A. The processing unit 200 includes apower supply 202, an audio transducer 204, a data storage 206, a soundprocessor 208, an interface module 210, a transceiver 212, and aninductive coil 214, all of which may be connected directly or indirectlyvia circuitry 220. For illustrative purposes, the processing unit 200 isthe processing unit 110 depicted in FIG. 1A.

The power supply 202 supplies power to various components of theprocessing unit 200 and can be any suitable power supply, such as arechargeable or a non-rechargeable battery. In one example, the powersupply 202 is a battery that can be charged wirelessly, such as throughinductive charging. In another example, the power supply 202 is not areplaceable or rechargeable battery and is configured to provide powerto the components of the processing unit 200 for the operationallifespan of the processing unit 200. The power supply 202 also providespower to the implanted unit of the hearing prosthesis, such as one ofthe implanted units 112, 122 described with respect to FIG. 1 via theinductive coil 214.

The audio transducer 204 receives a sound from an environment and sendsa sound signal to the sound processor 208. In one example, theprocessing unit 200 is a bone conduction device, and the audiotransducer 204 is an omnidirectional microphone. In another example, theprocessing unit 200 is a cochlear implant, an auditory brain stemimplant, a direct acoustic stimulation device, a middle ear implant, orany other hearing prosthesis now known or later developed that issuitable for assisting a user of the hearing prosthesis 101 inperceiving sound. In this example, the audio transducer 204 is anomnidirectional microphone, a directional microphone, anelectro-mechanical transducer, or any other audio transducer now knownor later developed suitable for use in the type of hearing prosthesisemployed. Furthermore, in other examples the audio transducer 204includes one or more additional audio transducers.

The data storage 206 includes any type of non-transitory, tangible,computer readable media now known or later developed configurable tostore program code for execution by a component of the processing unit200 and/or other data associated with the processing unit 200. The datastorage 206 also stores information indicative of a mapping curve forthe electrodes L1-L9 of the electrode array 114. The data storage 206may also store computer programs executable by the sound processor 208.

The sound processor 208 is configured to determine a stimulation signalsuitable for use by the implanted unit of the hearing prosthesis. In oneexample, the sound processor 208 is a digital signal processor. Inanother example, the sound processor 208 is any processor or combinationof processors now known or later developed suitable for use in a hearingprosthesis. Additionally, the sound processor 208 may include additionalhardware for processing the audio signal, such as an analog-to-digitalconverter and/or one or more filters.

The stimulation signal includes information indicative of a stimuluscurrent for one or more of the electrodes L1-L9. In one example, thesound processor 208 determines the stimulation signal by processing thesound signal received from the audio transducer 204. In another example,such as during a fitting process, the sound processor 208 receives asignal from the computing device 106 that includes informationindicative of the stimulus current for one or more of the electrodesL1-L9. Alternatively, the sound processor 208 receives the sound signalfrom the computing device 106.

The sound processor 208 also receives an update signal from thecomputing device via the interface module 210. Once fitting iscompleted, the computing device 106 sends the update signal toprocessing unit 200 via the cable 130. The update signal includesinformation indicative of the mapping curves for one or more of theelectrodes L1-L9 as determined by the computing device 106. The soundprocessor 208 stores the information included in the update signal inthe data storage 206.

The interface module 210 is configured to receive the test signal and/orthe update signal from the computing device 106. The interface module210 includes a component suitable for receiving signals from thecomputing device 106 via a wired and/or a wireless connection. Uponreceiving a signal from the computing device 106, the interface module210 sends the signal to the sound processor 208. In another example, theinterface module 210 is configured to store the information included inthe update signal in the data storage 206.

The transceiver 212 receives the stimulation signal from the soundprocessor 208 and modulates the stimulation signal to form atransmission signal. The transmission signal also includes the powersignal received from the power supply 202. In one example, thetransceiver 212 modulates the stimulation signal using a time-divisionmultiple-access modulation scheme. In another example, the transceiver212 uses any modulation scheme now known or later developed suitable forinductively transmitting the stimulation signal to an implanted unit ofa hearing prosthesis. The transceiver 212 sends the transmission signalto the inductive coil 214.

The inductive coil 214 receives the transmission signal from thetransceiver 212 and inductively transmits the transmission signal to theimplanted unit 112. The inductive coil 214 is constructed of anymaterial or combination of materials suitable for inductivelytransferring a power signal to the implanted unit.

FIG. 3 is a block diagram of an implanted unit 300 of a hearingprosthesis. The implanted unit 300 is one example of the implanted units112, 124 depicted in FIG. 1A. The implanted unit 300 includes aninductive coil 302, power management 304, and a stimulation decoder 306,all of which are connected directly or indirectly via circuitry 310. Theimplanted unit 300 also includes a stimulation component 310 that isconnected to the stimulation decoder 306 via circuitry 312. Forillustrative purposes, the implanted unit 300 is the implanted unit 112depicted in FIG. 1A.

The inductive coil 302 receives the transmission signal from theprocessing unit 110. The inductive coil 302 is constructed of anybiocompatible material or combination of materials suitable forinductively receiving power from the processing unit 110. The inductivecoil 302 transfers the power signal to the power management 304.Alternatively, the implanted unit 304 may not include the powermanagement 304. In this case, the inductive coil 302 transfers the powersignal to the stimulation decoder 306 and the stimulation component 308.

The power management 304 receives the transmission signal from theinductive coil 302 and distributes power to the components of theimplanted unit 300. The power management 304 also includes a componentsuitable for removing the coded stimulation signal from the powersignal. The power management 304 sends the coded stimulation signal tothe stimulation decoder 306. The stimulation decoder 306 decodes thecoded stimulation signal and transfers the stimulation signal to thestimulation component 308.

The stimulation component 308 receives the stimulation signal from thestimulation decoder 306 and generates a stimulus based on thestimulation signal. In one example, the stimulation component 308includes a first subcomponent configured to generate the stimulus and asecond subcomponent configured to deliver the stimulus to an auditoryorgan, such as a cochlea, an auditory nerve, a brain, and any otherorgan or body part capable of assisting a user of the hearing prosthesisin perceiving at least a portion of a sound. The first subcomponentgenerates the stimulus based on the stimulation signal and sends thestimulus to the second component. The second subcomponent delivers thestimulus to the body part of the user.

For instance, since implanted unit 300 is part of a cochlear implant,the stimulation component 308 includes a signal generator and theelectrode array 114. The signal generator generates an electrical signalbased on the stimulation signal and sends the electrical signal to theelectrode array 114. The electrical signal causes one or more of theelectrodes L1-L9 to deliver one or more electrical stimuli to a portionof the user's left cochlea. The one or more electrical stimuli cause theleft cochlea to stimulate the user's left auditory nerve, therebyallowing the user to perceive at least a portion of a sound from theuser's left ear.

FIG. 4A is a block diagram of a computing device 400. The computingdevice 400 is one example of the computing device 106 depicted in FIG.1A. The computing device 400 includes a power supply 402, a userinterface module 404, a data storage 406, a processor 408, and anexternal interface module 410, all of which are connected eitherdirectly or indirectly via circuitry 420. For illustrative purposes, thecomputing device 400 is the computing device 106 depicted in FIG. 1A.

The power supply 402 provides power to components of the computingdevice 400. In one example, the power supply 402 is connected to a mainspower distribution, such as an electrical outlet that supplies 120 VACpower. The power supply 402 includes electrical equipment, such as oneor more transformers, that are configured to reduce the power receivedfrom the mains power distribution to a voltage suitable for use by thecomponent of the computing device 400. The power supply 402 alsoincludes one or more AC-DC converters. In another example, the powersupply 402 includes a rechargeable battery configured to supply power tothe components of the computing device 402.

The user interface module 404 is configured to receive an input from theuser of the computing device 400 and to provide an output to the user.The user interface module 404 includes at least one input componentcapable of receiving an input from the user, such as a keyboard, akeypad, a computer mouse, a touch screen, a track ball, a joystick,and/or any other similar device now known or later discovered. The userinterface module 404 includes at least one output component capable ofdisplaying information to the user, such as a monitor, touch screen,printer, speaker, and/or any other similar device now known or laterdiscovered.

The user interface module 404 also includes a fitting interfaceconfigured to adjust values of stimulus currents applied by aninteraural electrode pair of a hearing prosthesis. FIG. 4B illustratesan example fitting interface 440. The fitting interface 440 includes avolume increase button 442, a volume decrease button 444, a left adjustbutton 446, a right adjust button 448, and a play button 450. In oneexample, the fitting interface 440 is included as part of a physicalinput interface, such as a keyboard or similar device. In anotherexample, the fitting interface 440 is displayed on an output componentof a display device, such as a monitor, touch screen, or similar outputcomponent. In this example, the user interacts with fitting interface440 using a mouse, a touch screen, or a similar input device.

During the fitting process, the user (or an audiologist or otherspecialist) adjusts the stimulus currents applied by one or moreinteraural electrode pairs. For example, consider a situation where theuser is adjusting the currents applied by an interaural electrode pairthat includes the electrodes L1 and R1. If the user presses the increasevolume button 442, the stimulus currents of both of electrodes L1 and R1are increased. If the user presses the decrease volume button 444, thestimulus currents of both of electrodes L1 and R1 are decreased. If theuser presses the left adjust button 446, the stimulus current of theelectrode L1 is increased, and/or the stimulus current of the electrodeR1 is decreased. If the user presses the right adjust button 448, thestimulus current of the electrode R1 is increased, and/or the stimuluscurrent of the electrode L1 is decreased.

In another example, the user interacts with the user interface 440 toadjust the stimulus current of one of the electrodes L1, R1individually. For instance, pressing the left adjust button 446 increasethe stimulus current of the electrode L1, and pressing the right adjustbutton 448 decreases the stimulus current of the electrode L1.Similarly, pressing the increase volume button 442 increase the stimuluscurrent of the electrode R1, and pressing the volume decrease button 444decreases the stimulus current of the electrode R1.

As an additional illustration of the operation of the fitting interface440, consider an example in which an initial stimulus current of theelectrode L1 is 150 units and an initial stimulus current of theelectrode R1 is 150 units, which are represented as 150/150. In thisexample, interacting with one of the buttons 442-448 changes thestimulus currents of the left and right electrodes by one unit.Depressing the increase volume button 442 changes the stimulus currentsto 151/151, while depressing the decrease volume button 444 changes thestimulus currents to 149/149. Similarly, depressing the left adjustbutton 446 changes the stimulus currents to 151/149, and depressing theright adjust button 448 changes the stimulation current to 149/151. Inanother example, depressing one of the buttons 442-448 changes thestimulus currents by a different amount. In yet another example, theuser can determine the amount of the change in the stimulus currentprior to depressing one of the buttons 442-448.

In one example, the fitting interface 440 also includes a play button450 that allows the user to hear a sound using a present setting of thestimulus currents for the interaural electrode pair. The user is alsoable to cycle between interaural electrode pairs using the previous pairbutton 452 and the next pair button 454. In one example, an outputcomponent of the user interface module 404 provides the user with anoption to select one or more interaural electrode pairs. For instance,if the user selects the interaural electrode pairs L1-R1, L2-R2, andL3-R3, interacting with one of the buttons 442-448 adjusts the stimuluscurrent for each of the electrodes L1-L3 and R1-R3.

The data storage 406 includes any type of non-transitory, tangible,computer readable media now known or later developed configurable tostore program code for execution by the computing device 400 and/orother data associated with the computing device 400. The data storage406 stores information used by the processor 408 to fit the bilateralhearing prostheses 101, 102. The data storage 406 may also storecomputer programs executable by the processor 408, such as computerprograms that include instructions for performing one or more steps ofthe methods described with respect to FIGS. 5A and 6.

The processor 408 is configured to fit the hearing prostheses 101, 102to the user. In one example, the processor 408 executes a computerprogram stored in the data storage 406 to fit the hearing prostheses101, 102. When fitting the hearing prostheses 101, 102, the processor408 generates one or more test signals that are sent to the processingunits 110, 120 via the external interface module 410. Based on inputsreceived via the user interface module 404, the processor 408 adjuststhe stimulus currents of one or more of the electrodes L1-L9, R1-R9.Once fitting is complete, the processor 408 determines mapping curvesfor each of the electrodes L1-L9, R1-R9. The processor 408 thengenerates a first update signal that include information indicative ofthe mapping curves for the electrodes L1-L9, and a second update signalthat includes information indicative of the mapping curves for theelectrodes R1-R9. The processor 408 sends the first updates signal tothe first processing unit 110 and the second update signal to the secondprocessing unit 120 via the external interface module 410. In oneexample, the processor 408 also stores the mapping curves for theelectrodes L1-L9, R1-R9 in the data storage 406 and/or the database 430.

The external interface module 410 connects the computing device 400 toone or more external devices, such as the hearing prostheses 101, 102,the database 430, and/or the second computing device 432. The externalinterface module 410 includes a component suitable for connecting thecomputing device 400 to the one or more external devices via a wiredand/or wireless connection.

3. EXAMPLE METHODS FOR FITTING A BILATERAL HEARING PROSTHESIS

FIG. 5A is a flow diagram of a method 500 for fitting bilateral hearingprostheses. A computing device may utilize the method 500 to determinecontrol settings for hearing prostheses. While the fitting system 100,the processing unit 200, and the computing device 400 are described forpurposes of illustrating the method 500, it is understood that otherdevices may be used.

The method 500 and other methods and processes disclosed herein mayinclude one or more operations, functions, or actions as illustrated inthe blocks. Although the blocks are illustrated in sequential order,these blocks may be performed in parallel and/or in a different orderthan that described herein. Also, the various blocks may be combinedinto fewer blocks, divided into additional blocks, and/or removed basedupon the desired implementation.

In addition, for the method 500 and other processes and methodsdisclosed herein, the flow diagram shows functionality and operation ofone possible implementation of one example. In this regard, each blockmay represent a module, a segment, or a portion of program code, whichincludes one or more instructions executable by a process forimplementing specific logical functions or steps in the process. Theprogram code may be stored on any type of computer readable medium, suchas a storage device including a disk or hard drive, for example. Thecomputer readable medium may include non-transitory computer readablemedia, such as a computer readable media that stores data for a shortperiod of time, such as register memory, processor cache, or RandomAccess Memory (“RAM”). The computer readable medium may also includenon-transitory computer readable media suitable as secondary orpersistent long term storage, such as read-only memory (“ROM”), one-timeprogrammable memory (OTP), or the like. The computer readable medium mayalso include any other volatile or non-volatile storage systems. Thecomputer readable medium may be considered computer readable storagemedium, for example, or a tangible storage device.

Furthermore, for the method 500 and other processes and methodsdiscussed herein, each block of FIG. 5A may represent circuitry that iswired to perform the specific logical functions of the process.

The method 500 is one example of a method for fitting the hearingprostheses 101, 102 by causing the electrodes in an interaural electrodepair to simultaneously stimulate the user's cochleae. With regard tostimulating the user's cochleae, “simultaneously,” as used herein, meansthe electrodes in an interaural electrode pair stimulate the user'scochleae such that the user perceives a sound in both ears at the sametime. Thus, the phrases “simultaneously stimulate,” “deliveredsimultaneously,” “simultaneously cause,” and the like should not beunderstood as requiring signals and/or stimuli to be delivered and/orreceived at exactly the same time. Rather, such phrases should beunderstood as indicating that there is an overlap between the deliveryand/or reception of the signals and/or stimuli that allow the user toperceive a single sound rather separates sounds from the user's left earand right ear.

How the user of the hearing prostheses 101, 102 perceives a location ofthe sound depends on how the user's brain “fuses”—or processes—soundsreceived from the user's left auditory pathway and right auditorypathway. As used herein, the term “auditory pathway” refers to the bodyparts between the user's outer ear and brain that allow the user toperceive sound. When the brain receives auditory signals from the leftauditory pathway and right auditory pathway, the brain processes thesounds together, which assists the user in locating the origin of thesound.

FIG. 5B illustrates possible perceptual locations of a sound in the head520 of the user. When the user's brain fuses a sounds received by theleft auditory pathway and the right auditory pathway, the user perceivesthe sound as being between the left ear 524 and the right ear 526, asillustrated by the spectrum 530. When the hearing prostheses 101, 102are fitted independently, the user may develop a bias toward the earwith less hearing loss. For example, consider a user having greaterhearing loss in the user's left auditory pathway than the user's rightauditory pathway. Fitting the hearing prostheses 101, 102 independentlymay cause the user to develop a bias toward the right side of thespectrum 530.

Such biases can cause the user to misperceive the origin of the sound.For instance, if the user perceives a sound as being left of center orleft on the spectrum 530 when a person with normal hearing wouldperceive the sound as being approximately centered, the user will havedifficulty identifying the source of the sound. Depending on thesituation, the misperception of the origin of a sound may be anannoyance (e.g., the user has difficulty locating a person in a crowdcalling the user's name) or a safety risk (the user misidentifies thesource of a car horn when crossing a street).

Fitting the hearing prostheses 101, 102 in parallel allows the user toidentify potential biases due to different levels of hearing loss in theuser's auditory pathways at different frequencies. As described herein,the user can utilize the computing device 106 to simultaneouslystimulate interaural electrode pairs. The user can adjust the stimuluscurrents for one or more electrodes in an interaural electrode pair suchthat the user perceives a tone as being approximately centered betweenon the spectrum 530. This allows the user to perceive sounds over arange of frequencies more like a person with normal hearing, allowingthe user to more accurately identify the source of a sound in anenvironment. Additionally, fitting the hearing prostheses 101, 102 inparallel reduces the amount of time taken to fit the hearing prostheses101, 102 to the user.

Returning to FIG. 5A, the method 500 includes determining a T-Level foreach of the electrodes L1-L9, R1-R9 of the hearing prostheses 101, 102,at block 502. The computing device 106 determines the T-Levels for theelectrodes L1-L9, R1-R9 individually. To determine the T-Level of theelectrode L1, the computing device 106 sends a test signal to the firstprocessing unit 110 that causes the electrode L1 to deliver a stimulusto the user's left cochlea using an initial stimulus current. The firstprocessing unit 110 processes the test signal and sends the stimulationsignal to the first implanted unit 112, which causes the electrode L1 todeliver the electrical stimulus to the user's left cochlea using theinitial stimulus current.

Upon delivery of the electrical stimulus, the user perceives a tone, thefrequency of which depends on the region of the user's left cochleabeing stimulated. Based on the user's perception of the tone (e.g., thetone's loudness), the user interacts with an input component of the userinterface module 404 to raise or lower the stimulus current of theelectrode L1 until the user can barely hear the tone. That is, the useradjusts the stimulus current of the electrode L1 until the useridentifies a lowest current at which the user can perceive the tone. Inone example, the input component is the fitting interface 440.

Once the user has identified the stimulus current below which the usercannot hear the tone, the computing device 106 determines that thestimulus current is the T-Level for the electrode L1. The computingdevice 106 repeats this process to determine T-Levels for the remainingelectrodes L2-L9 of the first electrode array 114 and the electrodesR1-R9 of the second electrode array 124.

Other procedures for determining the T-Levels of the electrodes L1-L9,R1-R9 are also possible. In one example, the computing device 106 sendsa test signal to one of the processing units 110 that causes a group ofelectrodes to stimulate the user's left cochlea, such as a group ofelectrodes that includes the electrodes L1-L3. The resulting stimulicause the user to perceive a multi-tonal sound. The user adjusts thestimulus currents for the group of electrodes until the user identifiesthe current below which the user cannot perceive the multi-tonal sound.Once the user has identified the stimulus current below which the usercannot hear the tone, the computing device 106 determines that thecorresponding stimulus currents are the T-Levels for the electrodesL1-L3. The computing device 106 repeats this process for the remainingelectrodes on each of the electrode arrays 114, 124 until the T-Levelsare determined for each of the electrodes L1-L9, R1-R9. In subsequentiterations of this process, the group of electrodes may contain more orfewer electrodes than the above-identified group.

In another example, the computing device 106 is configured to determinethe T-Levels for a subset of electrodes on an electrode array and tointerpolate the T-Levels of the remaining electrodes on the electrodearray. For instance, the computing device 106 determines the T-Levelsfor each of the electrodes L1, L3, L5, L7, and L9. The computing device106 then interpolates the T-Levels for the electrodes L2, L4, L6, and L8based on the T-Levels for the electrodes L1, L3, L5, L7, and L9. Thecomputing device 106 repeats the process for the electrodes R1-R9,perhaps by interpolating more or fewer T-Levels.

At block 504, the method 500 includes determining a C-Level for each ofthe electrodes L1-L9, R1-R9 of the hearing prostheses 101, 102 bystimulating interaural electrode pairs. The computing device 106 isconfigured to send the test signal to both processing units 110, 120when determining the C-Levels of interaural electrode pairs. The testsignal causes an interaural electrode pair, such as the interauralelectrode pair L1 and R1, to simultaneously deliver electrical stimulito the user's cochleae using an initial maximum stimulus current. Theinitial maximum stimulus current is a predetermined offset above theT-Level. For instance, if the T-Level is 100 units of current and theoffset is 20 units of current, then the initial maximum stimulus currentis 120 units of current.

Simultaneous stimulation of the user's cochleae causes the user toperceive a tone in both of the user's ears. In one example, a slightoffset exists between a delivery of a stimulus current from theelectrode L1 and a delivery of a stimulus current from the electrode R1.The offset may cause the user to incorrectly perceive a perceptuallocation of the tone on the spectrum 530. To account for the possibleoffset, the currents of the stimuli delivered by the electrodes L1 andR1 are ramped up to the initial maximum stimulus current. In thisexample, the computing device 106 sends a series of test signals to theprocessing units 110, 120 that increase the current of the stimulidelivered by the electrodes L1, R1 from the respective T-Levels to theinitial maximum stimulus current.

How the user perceives the tone depends on a number of factors, such as,for instance, the severity of the user's hearing loss in each ear andthe placement of electrodes in the user's cochleae. For example, if theuser has more severe hearing loss in the user's right ear than theuser's left ear, the user may perceive the tone as being located betweenleft or right of the center position on the spectrum 530. In oneexample, the user perceives the tone as being louder in the one ear thanthe other.

To account for the differences in interaural hearing loss, the userinteracts with the fitting interface 440 to adjust the stimulus currentsof the electrodes L1 and R1 until the user perceives the tone as beingapproximately centered between the user's ears.

The user also interacts with the fitting interface 440 to increase ordecrease the stimulus currents of the electrodes L1 and R1 until theuser substantially centers the tone between the user's ears andidentifies the currents above which the loudness of the tone is tooloud. The computing device 106 then determines that the stimuluscurrents for the electrodes L1 and R1 are the C-Levels for theelectrodes L1 and R1, respectively. The computing device 106 repeatsthis process for determining the C-Levels for additional interauralelectrode pairs until the computing device 106 determines the C-Levelfor each of the electrodes L1-L9, R1-R9.

Other procedures for determining the C-Levels of the electrodes L1-L9and R1-R9 are also possible. In one example, the computing device 106sends a test signal to the processing units 110, 120 that causes a groupof interaural electrode pairs to stimulate the user's cochleae, such asa group that includes the interaural electrode pairs L1-R1, L2-R2, andL3-R3. When the processing units 110, 120 send the resulting stimulationsignals to the implanted units 112, 122, the implanted units 112, 122cause the electrodes L1-L3 and R1-R3 to simultaneously stimulate theuser's cochleae. Consequently, the user perceives a multi-tonal sound.The user adjusts the stimulus currents of the interaural electrode pairsuntil the user identifies the stimulus currents in which the multi-tonalsound is approximately centered between the user's ears and above whichthe user perceives the multi-tonal sound as being too loud. Thecomputing device 106 then determines that the stimulus level of each ofthe electrodes L1-L3, R1-R3 is the electrode's C-Level. The computingdevice 106 repeats this process for the remaining electrodes on theelectrode arrays 114, 124 until the computing device 106 determines theC-Level for each electrode. In subsequent iterations of this process,the group of interaural electrode pairs may contain more or fewerinteraural electrode pairs than the above-described group.

In another example, the computing device 106 is configured to determinethe C-Level for a subset of interaural electrode pairs and tointerpolate the C-Levels of the remaining electrodes based on thedetermined C-levels. For example, the computing device 106 determinesthe C-Levels for the interaural electrode pairs L1-R1, L3-R3, L5-R5,L7-R7, and L9-R9. The computing device 106 then interpolates theC-Levels for the remaining electrodes L2, L4, L6, L8, R2, R4, R6, R8based on the C-Levels of the electrodes L1, L3, L5, L7, L9, R1, R3, R5,R7, and R9.

At block 506, the method 500 includes the computing device 106 receivinga request to fine-tune the mapping curves of the electrodes L1-L9,R1-R9. In one example, the user wishes to fine-tune the mapping curvesfor one or more interaural electrode pairs to more closely match theuser's ability to perceive a sound at one or more frequencies. The userinteracts with the user interface module 404, such as a mouse, akeyboard, or a touch screen, to select an option to fine tune one ormore mapping curves. For example, the computing device 106 causes theuser interface module 404 to display a dialog box on an outputcomponent, such as a monitor, display screen, or a touch screen. Thedialog box asks the user to select to fine tune one or more mappingcurves or to complete the fitting process. The user makes a selection byinteracting with an input component of the user interface 404, such as amouse or a keyboard.

At block 508, the method 500 includes determining whether the userrequested to fine tune one or more mapping curves. If the user requestedto determine one or more fine-tuned mapping curves, the method 500includes determining the one or more fine-tuned mapping curves, at block510. An example method for determining one or more fine-tuned mappingcurve is described with respect to FIG. 6 herein.

If the user did not request to determine one or more fine-tuned mappingcurves, the method 500 includes the computing device 106 sending theupdate signals to the processing units 110, 120, at block 512. Thecomputing device 106 sends the first update signal, which includesinformation indicative of the mapping curve for each of electrodesL1-L9, to the first processing unit 110, and the computing device 106sends the second update signal, which includes information indicative ofthe mapping curve for each of electrodes R1-R9, to the second processingunit 120. For each of the electrodes L1-L9, R1-R9, the informationindicative of the mapping curve includes at least the electrode'sT-Level and C-Level.

If the computing device 106 determined a fine-tuned mapping curve forone or more of the electrodes L1-L9, R1-R9, the computing device 106includes information of the fine-tuned mapping curve in the updatesignals sent to processing units 110, 120. For instance, if thecomputing device 106 determined a fine-tuned mapping curve for theelectrode L1, the computing device 106 includes information indicativeof the fine-tuned mapping curve in the first update signal. Once thecomputing device 106 completes the steps of block 512, the method 500ends.

FIG. 6 is a flow diagram of a method 600 for determining one or morefine-tuned mapping curves. The method 600 is one example of a methodthat may be employed at block 510 of the method 500. While the fittingsystem 100, the processing unit 200, and the computing device 400 aredescribed for purposes of illustrating the method 600, it is understoodthat other devices may be used.

To determine the one or more fine-tuned mapping curves, the computingdevice 106 “sweeps” through the electrode arrays 114, 124 by causing oneor more interaural electrode pairs to sequentially stimulate the user'scochleae. Sweeping through the electrode arrays 114, 124 in this mannerallows the user to perceive a series of tones sequentially (e.g., theuser perceives a sequence of tones in which the frequency of each toneincreases). The user can then identify a frequency at which a tone isnot substantially centered on the spectrum 530 and/or a frequency atwhich the tone does not have the same loudness as other tones during thesweep. The user then interacts with the fitting interface 440 to adjustthe stimulus currents of one or more interaural electrode pairs in orderto center each tone between the user's ears and to equalize the loudnessof the tones. The computing device 106 adjusts the mapping curves of oneor more of the electrodes L1-L9, R1-R9 by sweeping uses the adjustedstimulus currents to determine the fine-tuned mapping curves for one ormore of the electrodes L1-L9, R1-R9.

At block 602, the method 600 includes the computing device 106determining a sweep SPL. The sweep SPL is used to determine the stimuluscurrent for each electrode during a sweep of the electrode arrays 114,124. The sweep SPL is any SPL between SPL_(T) and SPL_(C). In oneexample, the sweep SPL is determined by the following formula:

Sweep SPL=SPL_(C)−(1−P)·(SPL_(C)−SPL_(T))

where P is a percentage in decimal form. Typically, the sweep SPL isgreater than SPL_(T); that is, P is greater than zero. Since the T-Levelrepresents the minimum stimulus current at which the user can perceive asound at a given frequency, the user may not be able to determine adifference between the perceptual locations and/or a difference in theloudness between two sequential tones. To better ensure the user is ableto distinguish differences in the loudness and location of the tones, Pis greater than a minimum percentage, such as about 25%, that willresult in tones of sufficient loudness that the user can clearlyperceive.

At block 604, the method 600 includes the computing device performing asweep of the interaural electrode pairs. To perform the sweep, thecomputing device 106 successively sends test signals to the processingunit 110, 120 that cause interaural pairs of electrodes to sequentiallystimulate the user's cochleae. For example, the computing device 106 maysend a first test signal to the processing units 110, 120 that causesthe electrodes L1 and R1 to simultaneously stimulate the user'scochleae. The computing device 106 then sends a second test signal tothe processing units 110, 120 that causes the electrodes L2 and R2 tosimultaneously stimulate the user's cochleae. The computing device 106continues sending test signals to the processing units 110, 120 untileach interaural electrode pair has stimulated the user's cochleae.

The duration of each test signal is of sufficient length to allow theuser to perceive each tone. That is, the computing device 106 does notsweep through the electrode arrays 114, 124 so quickly that the usercannot distinguish each tone. In one example, the duration of each testsignal is about 500 msec. In another example, the user can adjust theduration of the test signals.

Additionally, the computing device 106 may send a plurality of testsignals to the processing units 110, 120 for each interaural electrodepair that causes the stimulus currents for the interaural electrode pairto ramp up to the stimulus current corresponding to the sweep SPL.Ramping the stimulus currents to the stimulus current corresponding tothe sweep SPL provides a control for a potential timing offset indelivery of the stimulus currents, which could affect the userdetermining the perceptual location of a sound.

In one example, the computing device 106 does not sweep through eachelectrode on the electrode arrays 114, 124. In this example, the userselects a group of interaural electrode pairs that the computing deviceuses during the sweep of the electrode arrays. For instance, thecomputing device 106 sends test signals to the processing units 110, 120that cause the interaural electrode pairs L1-R1, L3-R3, and L6-R6 tosequentially stimulate the user's cochleae. In another example, the testsignals cause groups of interaural electrode pairs to simultaneouslystimulate the user's cochleae. For example, the first test signal causesthe interaural electrode pairs L1-R1 and L2-R2 to stimulate the user'scochleae, and the second test signal causes the interaural electrodepairs L3-R3 and L4-R4 to stimulate the user's cochleae. In yet anotherexample, the test signals cause more or fewer interaural electrode pairsto simultaneously stimulate the user's cochleae.

At block 606, the method 600 includes the computing device 106 receivingan adjustment to an interaural electrode pairs via the fitting interface440. If the user identified one or more stimulus currents that requirean adjustment during or after the sweep, the user adjusts the stimuluscurrents of one or more interaural electrode pairs in order tosubstantially center each tone between the user's ears and to match theloudness of the tones the user perceived during the sweep.

At block 608, the method 600 includes the computing device 106determining whether an adjustment to a stimulus current was received. Ifthe computing device 106 determines that an adjustment to a stimuluscurrent was received, the method 600 includes returning to block 604 toperform an additional sweep using the adjusted stimulus currents.Otherwise, the method 600 proceeds to block 610.

At block 610, the method 600 includes determining if there areadditional sweeps to perform. Typically, the computing device 106performs sweeps using at least two sweep SPLs. The user may interactwith an input component of the user interface 404 to select additionalsweep SPLs. Alternatively, the additional sweep SPLs may bepredetermined. In another example, the user interacts with userinterface module 404 to cause the computing device 106 to perform asingle sweep. If the computing device 106 determines that there areadditional sweeps to perform, the sweep SPL is set to the next SPL atblock 612. The method 600 then includes returning to block 604 toperform an additional sweep of the electrode arrays 114, 124 using thenext SPL.

If the computing device 106 determines that the requested sweeps havebeen performed, the method 600 includes the computing device 106determining one or more fine-tuned mapping curves, at block 614. Foreach electrode that delivered a stimulus during the sweep, the computingdevice 106 determines the fine-tuned mapping curve based on the stimuluscurrents determined during the sweep(s) of the electrode arrays 114,124. After the computing device 106 completes the steps of block 614,the method 600 ends.

FIGS. 7A-7C illustrate example fine-tuned mapping curves for anelectrode determined using the method 600. For illustrative purposes,the electrode L1 depicted in FIG. 1C is used to describe FIGS. 7A-7C.

The mapping curves illustrated in FIGS. 7A-7B are based on two sweepswhere P is 50% (SPL_(50%)) and 100% (SPL_(C)). In another example,different values of P are used to develop fine-tuned mapping curves.FIG. 7A illustrates a graph 700 of three mapping curves: mapping curveA, mapping curve B, and mapping curve C. Mapping curve A is an initialmapping curve of the electrode L1 based on an initial T-Level(T-Level_(A)) and an initial C-Level (C-Level_(A)). The I_(A) is thestimulus current of the electrode L1 at SPL_(50%). Mapping curve B is afine-tuned mapping curve determined in response to the user increasingthe stimulus current during the sweep at SPL_(50%) from IA to I_(B).Mapping curve C is a fine-tuned mapping curve determined in response tothe user decreasing the stimulus current during the sweep at SPL_(50%)from I_(A) to I_(C).

Mapping curves B-C illustrate how adjustments to the stimulus current atSPL_(50%) affect the dynamic range of the electrode. The C-Level for thethree mapping curves is the same because the user did not adjust thestimulus currents corresponding to SPL_(C). Since I_(B) is greater thanI_(A), the slope of mapping curve B is less than the slope of mappingcurve A. As a result, the T-Level for mapping curve B (T-Level_(B)) isgreater than the T-Level_(A). In contrast, since I_(C) is less thanI_(A), the slope of mapping curve C is greater than the slope of mappingcurve A, and the T-Level for mapping curve C (T-Level_(C)) is less thanT-Level_(A).

FIG. 7B illustrates a second graph 702 of three mapping curves: mappingcurve A, mapping curve D, and mapping curve E. Mapping curve A is thesame as or is substantially similar to mapping curve A as described withrespect to FIG. 7A. Mapping curve D is a mapping curve determined inresponse to the user increasing the stimulus current during the sweep atSPL_(C) from C-Level_(A) to C-Level_(D). Mapping curve E is a mappingcurve determined in response to the user increasing the stimulus currentduring the sweep at SPL_(C) to C-Level_(D) and increasing the stimuluscurrent during the sweep at SPL_(50%) from I_(A) to I_(E).

Mapping curves D-E illustrate how adjustments to the stimulus current atSPL_(C) and/or SPL_(50%) affect the dynamic range of the electrode.C-Level_(A) is less than C-Level_(D), but the stimulus currents atSPL_(50%) for mapping curve A and mapping curve D is the same. Thus, theslope of mapping curve D is greater than the slope of mapping curve A,and the T-Level for mapping curve D (T-Level_(D)) is less than theT-Level_(A). For mapping curve E, a difference between I_(E) and I_(A)is about the same as a difference between C-Level_(D) and C-Level_(A).Thus, the slope of mapping curve E is about the same as the slope ofmapping curve A, but the T-Level for mapping curve E (T-Level_(E)) isgreater than T-Level_(A).

FIG. 7C illustrates a graph 704 of two mapping curves: mapping curve Aand mapping curve F. Mapping curve A is the same as or is substantiallysimilar to mapping curve A as described with respect to FIG. 7A. Mappingcurve F is a mapping curve based on three sweeps where P is 50%(SPL_(50%)), 75% (SPL_(75%)), and 100%. Mapping curve F is a mappingcurve determined in response to the user increasing the stimulus currentduring the sweep at SPL_(C) from to C-Level_(F), decreasing the stimuluscurrent during the sweep at SPL_(75%) from I_(A1) to I_(F1), anddecreasing the current at SPL_(50%) from I_(A2) to I_(F2).

Mapping curve F illustrates how adjustments to the stimulus currents atmore than two sweep SPLs affects the dynamic range of the electrode.C-Level_(A) is less than C-Level_(F), but I_(A1) is greater than I_(F1).Thus, the slope of mapping curve F is greater than the slope of mappingcurve A between SPL_(75%) and SPL_(C). The change in the stimuluscurrent at SPL_(50%) from I_(A2) to I_(F2) causes a change in the slopeof mapping curve F between SPL_(T) and SPL_(50%). The slope of mappingcurve F between SPL_(75%) and SPL_(C) is greater than the slope ofmapping curve F between SPL_(T) and SPL_(50%). Since the slope ofmapping curve A is less than the slope of mapping curve F betweenSPL_(T) and SPL_(75%), T-Level_(A) is greater than T-Level_(F).

As the graphs 700, 702, and 704 illustrate, fine-tuning the mappingcurve of an electrode may result in an adjustment to the T-Level of theelectrode. Since the T-Level is the level below which the user is unableto perceive a sound and is determined for each electrode individually,fine-tuning the dynamic range may result in a more accurate setting forthe T-Level. Additionally, fine-tuning the mapping curve results in amore accurate logarithmic relationship between the SPL of an incomingsound and a resulting stimulus current.

4. CONCLUSION

While the descriptions of methods 500 and 600 are based on the fittingsystem 100 including two cochlear implants, the computing device 106 mayemploy the methods 500 and/or 600 to fit bilateral hearing prosthesesthat are not cochlear implants. For instance, if the hearing prostheses101, 102 are bone conduction devices, the implanted units 112, 122include a left transducer and a right transducer, respectively, insteadof the electrode arrays 114, 124. In this example, the implanted units112, 122 use the transducers to cause vibrations on the user skullcapable of stimulating the user's cochleae. The computing device 106uses the method 500 to determine a minimum amplitude (e.g., T-Levels) ofthe vibrations for each transducer at a frequency and maximum amplitude(e.g., C-Levels) of the vibrations for each transducer at a frequency ofthe vibrations applied by simultaneously applying vibrations to theuser's skull using the left and right transducers.

While various aspects and embodiments have been disclosed herein, otheraspects and embodiments will be apparent to those skilled in the art.The various aspects and embodiments disclosed herein are for purposes ofillustration and are not intended to be limiting, with the true scopeand spirit being indicated by the following claims.

What is claimed is:
 1. A method comprising: sending a signal to a firsthearing prosthesis and a second hearing prosthesis, wherein the signalcauses: the first hearing prosthesis to deliver a first stimulus to abody part in a left auditory pathway of a user; and the second hearingprosthesis to deliver a second stimulus to a body part in a rightauditory pathway of the user, wherein the first stimulus and the secondstimulus cause the user to perceive a sound, and wherein the firststimulus and the second stimulus are delivered simultaneously; receivingan indication of a perception of the sound by the user; and determiningan adjustment to at least one of the first stimulus or the secondstimulus based on the perception of the sound by the user.
 2. The methodof claim 1, wherein the adjustment includes an increase in at least oneof the first stimulus or the second stimulus.
 3. The method of claim 1,wherein the adjustment includes a decrease in at least one of the firststimulus and the second stimulus.
 4. The method of claim 1, wherein theadjustment includes an increase in the first stimulus and a decrease inthe second stimulus.
 5. The method of claim 1, wherein the adjustmentincludes a decrease in the first stimulus and an increase in the secondstimulus.
 6. The method of claim 1, wherein: the first body part is aleft cochlea; the second body part is a right cochlea; the first hearingprosthesis is a first cochlear implant that includes a first electrodearray implanted in the left cochlea, wherein the first electrode arrayincludes one or more electrodes; and the second hearing prosthesis is asecond cochlear implant that includes a second electrode array implantedin the right cochlea, wherein the second electrode array includes one ormore electrodes.
 7. The method of claim 6, wherein: the first stimulusis an electrical stimulus delivered to the left cochlea by at least oneof the one or more electrodes included on the first electrode array; andthe second stimulus is an electrical stimulus delivered to the rightcochlea by at least one of the one or more electrodes included on thesecond electrode array.
 8. The method of claim 1, wherein the signalincludes information for increasing the first stimulus from a firstvalue to a second value, and wherein the signal includes information forincreasing the second stimulus from a third value to a fourth value. 9.The method of claim 1, wherein receiving the indication of theperception of the sound by the user includes receiving, at a userinterface, an input that includes information indicative of the userperceiving the sound as having a perceptual location other thanapproximately centered between the ears of the user.
 10. The method ofclaim 8, wherein the adjustment substantially centers the sound betweenthe ears of the user.
 11. A method comprising: sending a first signal toa first hearing prosthesis that includes information indicative of afirst stimulus, wherein the first hearing prosthesis delivers the firststimulus to a first body part in a left auditory pathway of a user;sending a second signal to a second hearing prosthesis that includesinformation indicative of a second stimulus, wherein the second hearingprosthesis delivers the second stimulus to a second body part in a rightauditory pathway of the user, and wherein the first stimulus and thesecond stimulus are delivered simultaneously; determining whether thefirst stimulus and the second stimulus are at a maximum level; and inresponse to determining that the first stimulus and the second stimulusare at the maximum level, determining that the first stimuluscorresponds to a maximum sound pressure level; and determining that thesecond stimulus corresponds to the maximum sound pressure level, whereinthe maximum sound pressure level is a sound pressure level of a soundabove which the sound is saturated.
 12. The method of claim 11, wherein,in response to determining that one of the first stimulus or the secondstimulus is above the maximum level, the method further comprisesdetermining a decrease to one of the first stimulus or the secondstimulus.
 13. The method of claim 11, wherein, in response todetermining that one of the first stimulus or the second stimulus isbelow the maximum level, the method further comprises determining anincrease to one of the first stimulus or the second stimulus.
 14. Themethod of claim 11, further comprising: sending a first output signal tothe first hearing prosthesis that includes information indicative of thefirst stimulus corresponding to the maximum sound pressure level; andsending a second output signal to the second hearing prosthesis thatincludes information indicative of the second stimulus corresponding tothe maximum sound pressure level.
 15. The method of claim 11, wherein:the first body part is a left cochlea; the second body part is a rightcochlea; the first hearing prosthesis is a first cochlear implant thatincludes a first electrode implanted in the left cochlea, wherein thefirst electrode delivers the first stimulus by applying a first stimuluscurrent to the left cochlea; and the second hearing prosthesis is asecond cochlear implant that includes a second electrode implanted inthe right cochlea, wherein the second electrode delivers the secondstimulus by applying a second stimulus current to the right cochlea. 16.The method of claim 15, wherein the first signal includes informationindicative of the first stimulus current, and wherein the second signalincludes information indicative of the second stimulus current.
 17. Themethod of claim 16, wherein the first hearing prosthesis delivers thefirst stimulus by increasing a stimulus current of the first electrodefrom a first current to the first stimulus current; and the secondhearing prosthesis delivers the second stimulus by increasing a stimuluscurrent of the second electrode from a second current to the secondstimulus current.
 18. The method of claim 11, further comprising:receiving an input that includes information indicative of a perceptuallocation of the sound between a left ear and a right ear of the user;determining whether the perceptual location of the sound isapproximately centered between the ears of the user.
 19. The method ofclaim 18, further comprising: in response to the determining that theperceptual location of the sound is closer to the left ear the user thanthe right ear of the user, decreasing the first stimulus and increasingthe second stimulus; and in response to determining that the perceptuallocation of the sound is closer to the right ear of the user than theleft ear the user, increasing the first stimulus and decreasing thesecond stimulus.
 20. A method comprising: performing a sweep ofelectrode arrays of bilateral hearing prostheses by: causing a firstinteraural electrode pair to deliver a first stimulation to a user ofthe bilateral hearing prostheses so that the user perceives a firstsound; and causing a second interaural electrode pair to deliver asecond stimulation to the user so that the user perceives a secondsound, wherein the second stimulation is delivered after the firststimulation; receiving an input signal that includes informationindicative of a difference between the first sound and the second soundas perceived by the user; determining an adjustment to a stimuluscurrent of an electrode included in one of the first interauralelectrode pair or the second interaural electrode pair based on theinput signal, wherein the stimulus current is a component of one of thefirst stimulation or the second stimulation; applying the adjustment toa mapping curve of the electrode, wherein the mapping curve includesinformation indicative of a plurality of stimulus currents correspondingto a plurality of sound pressure levels.
 21. The method of claim 20,wherein the mapping curve of the electrode represents relationshipbetween input sound pressure levels sound and stimulus currents of theelectrode that is substantially logarithmic between a threshold soundpressure level and a maximum sound pressure level, wherein the thresholdsound pressure level corresponds to a stimulus current for the electrodebelow which the user is unable to perceive a sound, and wherein themaximum sound pressure level is a saturation sound pressure level forthe electrode.
 22. The method of claim 21, wherein the stimulus currentcorresponds to a sweep sound pressure level on the mapping curve. 23.The method of claim 22, wherein: the sweep sound pressure level isgreater than the threshold sound pressure level; and the sweep soundpressure level is less than or equal to the maximum sound pressurelevel.
 24. The method of claim 22, wherein the adjustment is a decreasein the stimulus current, and wherein applying the adjustment to themapping curve: decreases the stimulus current corresponding to the sweepsound pressure level; and decreases one or more additional stimuluscurrents corresponding to one or more additional sound pressure levels.25. The method of claim 22, wherein the adjustment is an increase in thestimulus current, and wherein applying the adjustment to the mappingcurve: increases the stimulus current corresponding to the sweep soundpressure level; and increases one or more additional stimulus currentscorresponding to one or more additional sound pressure levels.
 26. Themethod of claim 20, wherein, after determining the adjustment, themethod further comprises: performing a second sweep of the electrodearrays by: causing the first interaural electrode pair to deliver athird stimulation to the user so that the user perceives a third sound;and causing a second interaural electrode pair to deliver a fourthstimulation to the user so that the user perceives a fourth sound,wherein the fourth stimulation is delivered after the third stimulation;receiving a second input signal that includes information indicative ofa second difference between the third sound and the fourth sound asperceived by the user; determining a second adjustment to a secondstimulus current of the electrode based on the second input signal,wherein the second stimulus current is a component of one of the thirdstimulation or the fourth stimulation; applying the second adjustment tothe mapping curve of the electrode.
 27. A system comprising: a firsthearing prosthesis that includes a first electrode array configured tostimulate a first body part of a user, wherein the first body part is abody part in a left auditory pathway of the user; a second hearingprosthesis that includes a second electrode array configured tostimulate a second body part of the user, wherein the second body partis a body part in a right auditory pathway of the user; and a computingdevice connected to the first cochlear implant and the second cochlearimplant, wherein the computing device is configured to fit the firstcochlear implant and the second cochlear implant to the user by: sendinga test signal to the first hearing prosthesis and the second hearingprosthesis that causes an interaural electrode pair to stimulate thefirst body part and the second body part so that the user perceives asound, wherein the interaural electrode pair includes a first electrodeincluded on the first electrode array and a second electrode included onthe second electrode array, and where the test signal includesinformation indicative of a first stimulus current for a stimulusapplied by the first electrode and a second stimulus current for astimulus applied by the second electrode; determining whether an inputsignal received at a user interface of the computing device includes arequest to adjust the sound; in response to determining that the inputsignal includes the request to adjust one of the first stimulus or thesecond stimulus, adjusting at least one of the first stimulus current orthe second stimulus current based on the request.
 28. The system ofclaim 27, wherein the request to adjust the sound includes a request toadjust a perceptual location of the sound as perceived by the user, andwherein adjusting at least one of the first stimulus current or thesecond stimulus current includes adjusting the first stimulus currentand the second stimulus current to substantially center the perceptuallocation of the sound between the ears of the user.
 29. The system ofclaim 27, wherein, in response to determining that the input signalincludes an absence of the request to adjust the sound, the methodfurther comprises: determining that the first stimulus currentcorresponds to a sound pressure level, wherein the test signal is basedon the sound pressure level; determining that the second stimuluscurrent corresponds to the sound pressure level; sending a first updatesignal to the first cochlear implant that includes informationindicative of the first stimulus corresponding to the sound pressurelevel; and sending a second update signal to the second cochlear implantthat includes information indicative of the second stimuluscorresponding to the sound pressure level.
 30. The system of claim 29,wherein the computing device is further configured to fit the firstcochlear implant and the second cochlear implant to the user by:interpolating one or more stimulus currents that correspond to the soundpressure level for one or more additional electrodes included on thefirst electrode array based on the first stimulus; and interpolating oneor more stimulus currents that correspond to the sound pressure levelfor one or more additional electrodes included on the second electrodearray based on the second stimulus.
 31. The system of claim 27, wherein:the interaural electrode pair includes one or more additional electrodesincluded on the first electrode array and one or more additionalelectrodes included on the second electrode array; the test signalincludes information indicative of one or more stimulus currents for theone or more additional electrodes included on the first electrode array;and the test signal includes information indicative of one or morestimulus currents for the one or more additional electrodes included onthe second electrode array.
 32. The system of claim 31, wherein, inresponse to determining that the input signal includes the request, themethod further comprises: adjusting at least one of: the first stimuluscurrent; the second stimulus current; the one or more stimulus currentsfor the one or more additional electrodes included on the firstelectrode array; or the one or more stimulus currents for the one ormore additional electrodes included on the second electrode array.
 33. Acomputing device comprising: a user interface configured to receive anindication of an adjustment to a first stimulus and a second stimulusdelivered to a user of a first hearing prosthesis and a second hearingprosthesis; an interface module configured to connect the computingdevice to the first hearing prosthesis and the second hearingprosthesis; and a processor configured to: receive an input signal fromthe user interface that includes information indicative of an adjustmentto the first stimulus and the second stimulus; modify the first stimulusand the second stimulus based on the adjustment; send a first signal tothe first hearing prosthesis that includes information indicative of amodified first stimulus; and send a second signal to the second hearingprosthesis that includes information indicative of a modified secondstimulus, wherein the first signal causes the first hearing prosthesisto deliver the modified first stimulus to the user at about a same timeas the second signal causes the second hearing prosthesis to deliver themodified second stimulus to the user.
 34. The computing device of claim33, wherein the user interface includes a first input interface, asecond input interface, a third input interface, and a fourth inputinterface.
 35. The computing device of claim 34, wherein an interactionwith the first input interface increases the first stimulus andincreases the second stimulus.
 36. The computing device of claim 34,wherein an interaction with the second input interface decreases thefirst stimulus and decreases the second stimulus.
 37. The computingdevice of claim 34, wherein an interaction with the third inputinterface increase the first stimulus and decreases the second stimulus.38. The computing device of claim 34, wherein an interaction with thefourth input interface decreases the first stimulus and increases thesecond stimulus.
 39. The computing device of claim 33, wherein the userinterface includes an external hardware component, and wherein the firstinput interface, the second input interface, the third input interface,and the fourth input interface are included on the external hardwarecomponent.
 40. The computing device of claim 33, wherein the userinterface includes a display device, and wherein the first inputinterface, the second input interface, the third input interface, andthe fourth input interface are displayed on the display device.